Mental Health - January 2010
New Horizons
The government’s new initiative sets out to achieve a
great deal, writes Kiran Bhogal, but it just might
work.
The path that has led to New Horizons began
with recognition that more had to be done to support those with
mental health problems. This in turn led to the introduction of the
National Service Framework for Mental Health (NSF).
Progress with the NSF was slow, but it has –
finally - yielded a better understanding, on the part of government
and professionals, of the fact that at any one time, one-in-six
adults will have mental health problems. What has not, however,
been commonly recognised is the toll that mental ill-health can
have on its victims, their families and friends, and on the public
at large.
The government’s new initiative, New
Horizons: a shared vision for mental health (New Horizons)
seeks to build on the transformation of mental health services that
began a decade ago. It recognises that, as the Secretary of
State says in his foreword, “for the first time, mental health and
wellbeing [are] not just a health concern, but… a major social
issue demanding action across all parts of the Government”.
The government has therefore stepped up its game, by setting
an extremely challenging timetable to take the transformation to
the next level.
New Horizons adopts a dual approach, combining
service-improvement with a new partnership of central and local
government, the third sector and the professions. A key aim
is encourage more people to recognise depression and the fact that
a failure to deal with it at an early stage can lead to other
mental health problems. The emphasis is on early identification and
treatment, and on improving the quality and accessibility of
services, which in turn (it is envisaged) will lead to the
improvement of the mental health and well-being of the
population. How is this to be achieved?
First, we are told, government departments
involved in New Horizons will establish a ministerial board to
ensure high-level oversight, with the Department of Health (DoH)
offering support and advice, both to the new board and to other
statutory agencies as they carry out mandatory impact
assessments. In addition, there will be a ministerial
advisory group, which will be chaired by the Minister of State for
Care Services, involve external stakeholders, and help monitor
progress and advise on strategy.
A plethora of guidance and other publications
is heading our way this spring, including a report on Public
Mental Health Framework and Review of Supporting Evidence, an
atlas for mental well-being in England and a violence and abuse
prevention framework. These will be supported by an online
cost calculator and a series of short briefings. Also to be
launched this year is WordsMatter, a voluntary sector-led
website, which will enable people to pass on their praise (or
complaints) to journalists writing about mental health issues, and
to provide expert support to NHS Trusts and SHAs over media
coverage of homicide inquiries.
Another approach announced by the government
in what it calls its ‘bold statement of intent’ is a focus on
‘personalisation’ – in other words, adopting a personal approach to
the way services are delivered. This is seen as fundamental if the
needs of individuals in the most vulnerable groups are to be
addressed. To this end, we are told, the DoH, the Future
Visions Coalition and other partners will shortly hold a summit on
personalisation and mental health, with a view to determining how
those with the greatest need can be best supported, whether there
is life beyond individualised budgets and how personalisation can
contribute to value-for-money.
Multi-agency collaboration and commissioning,
and value-for-money, form another key theme of New Horizons, with
the message that this is not about cost-cutting but about the
efficient use of the resources available. This is a
particularly welcome message in a NHS that faces a much harsher
financial environment: it is said that the financial cost of mental
ill-health will double over the next 20 years. New Horizons
seeks to draw in employers (the cost to them is around £26 billion
a year), education services (to raise awareness of the need for
early-intervention and to eliminate the stigma attached to mental
health), children’s and adolescent services (to ensure an effective
transition to adult services) and housing services and the ‘Third
Sector’ (to ensure that appropriate support is available in the
community).
The transformation of mental health services
was always going to be a mammoth task, but the good news is that we
seem to be heading in the right direction. With New Horizons
and the guidance that is to come later this year, there appears to
be light at the end of what has otherwise been a dark and
undulating tunnel. There remains much to be done, however,
and much to be read, but there is real hope for the millions of
people who suffer from, or who might have to face, mental health
problems.
Kiran Bhogal,
Partner
Weightmans LLP